Nottingham

Updated 19 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period of notice of the inspection so that the provider could let people know we were visiting and why.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from partner agencies including local authority and Health Watch UK. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

We spoke with 7 people and 3 relatives about their experience of the care provided. We spoke with 11 staff members. This included 7 care staff, 1 team leader, the duty manager, the quality and compliance manager, and the registered manager. We reviewed a range of records. This included 5 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including staff training information, health and safety audits, and policies and procedures were reviewed.

Updated 19 May 2023

About the service

Choice Support Nottingham provides care and support to people living in 'supported living' settings, which will be referred to as 'sites' in this report. The sites referred to are where people's homes are located. The sites were varied from people living in their own flats with access to a communal, shared, space where staff were based; to people living in small, shared living settings. People live at these sites with support from staff so that they can live as independently as possible. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

The service provides support to adults with a learning disability and autistic people. At the time of our inspection there were 45 people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Staff provided support to people which ensured they maintained good health. However, we found some examples of regular health care needs not being met. Medication was managed safely, and people were supported to access support from health professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by staff who had been safely recruited and were trained to be able to effectively support people.

Right Care

Systems were in place to provide management oversight and ensure regular quality and compliance checks were completed. However, managers had not coached all staff effectively which meant they were not always clear about their role in relation to the effective use of these systems. This meant issues that could impact people's care may not be identified.

Staff were respectful and supported people in a way that demonstrated they valued people's differences and equality needs. This was reflected in person-centred care plans and risk assessments.

People were supported to communicate using accessible information, and their diverse needs and choices were respected because they were receiving regular support from consistent staff including consistently used agency staff.

People were supported by friendly and caring staff, so people received compassionate care. Staff respected people’s choices and treated them with dignity.

Right Culture

Not all people were empowered to live inclusive lives that enabled them to achieve positive outcomes. We identified 1 specific individual that this applied to. However, the provider was taking action to resolve this. Other people were supported to live an inclusive life that promoted their independence.

Staff were appropriately trained for their role, so people received support from staff that understood how best to support them. However, not all staff were provided with consistent support and leadership to support continuous improvement and development.

The provider was open, honest and responsive in relation to feedback during the inspection and committed to make improvements based on this to improve people's quality of life.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 26 February 2020).

Why we inspected

The inspection was prompted in part due to concerns received about people’s nutritional and personal care needs not being adequately met, medicines and staffing, including management oversight at 1 specific site. A decision was made for us to inspect and examine those risks.

The provider has engaged team leaders and the duty manager to provide additional support for this site which has provided the staff team with support and guidance.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Choice Support, Nottingham on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.